Critical Differences Between Marketplace and Short-Term Coverage 

When you seek coverage, you may feel tempted by short-term medical indemnity policies, especially if you are in generally good health. However, before signing the dotted line, you must know the differences between such plans and standard insurance.

First of all, these insurers can disqualify you if you have an existing medical history. This arrangement causes severe disruptions with continuity of care.

Say you become sick with a disease like COVID-19 and develop long-hauler symptoms that cause repeated hospital visits. When your coverage period ends, your insurer could refuse to issue you a new policy. While nothing would prohibit you from switching to a Marketplace plan at that time, you might need to change doctors, causing an interruption in treatment. Even though medical records are electronic, physicians unacquainted with your unique needs can’t provide the quality of care that a dedicated health care team can.

Furthermore, many plans exclude coverage for things like mental health, maternity care or prescriptions. If you take medications or want to add a new family member without accruing substantial debt, a Marketplace plan is the way to go. Uncovered births can cost anywhere from $30,000 to $50,000 in the U.S.

However, short-term medical indemnity coverage does serve a purpose. If you work in an industry like construction with frequent layoffs based on weather patterns, such plans can help prevent bankruptcy if you get in an accident while not covered by an employer. They also come in handy for temporary economic hardship created by job loss.

In many cases, though, if you are a freelancer or self-employed individual, the Marketplace is your current best bet for ongoing coverage. Such policies must cover 10 essential benefits, including mental health and maternity care, and they can’t exclude you based upon your health history.

Marketplace Plans for Residents of Colorado 

Colorado has a vibrant Marketplace, and many residents will find at least 76 policies to choose from. You’ll find generous subsidies to help you get the care you need. You’ll find bronze-, silver- and gold-level coverage options depending on your needs.

1. Friday Health Plans

The bronze HMO plan from Friday Health Plans rings in at $331.80 monthly. It has an $8,550 annual deductible and out-of-pocket maximum. This plan does not offer separate prescription coverage, although you pay nothing for them after meeting your deductible. The same rules apply to primary care, specialist and hospital visits.

2. Bright Health 

The Bright Health bronze plan costs $336.73 a month and does cover generic prescriptions with a $40 copay and specialty ones for $650. Preferred brand drugs are $200, and non-preferred are $400. It has an $8,550 annual deductible and out-of-pocket maximum. Primary care and telehealth visits come with a $50 copay, but specialist visits are not covered until you meet your deductible.

3. Denver Health Medical Plan

The bronze-level plan from Denver Health costs $341.69 a month with an $8,550 deductible and annual out-of-pocket maximum. Generic drugs cost $60, specialty medications $710, preferred brands are $175.00 and non-preferred are $275.00. There is no charge for screenings, but primary care and specialty visits are covered only after meeting your deductible.

4. Oscar

The Oscar bronze-level plan features a $6,300 annual deductible and $8,550 out-of-pocket maximum. It costs $348.76 per month. Generic drugs cost $25, while specialty and brand-name medications have a 50% coinsurance after deductible. Primary care visits cost $50 with a 50% coinsurance after deductible, and specialists are not separately covered, with a 50% coinsurance after deductible.

5. Anthem

The bronze plan rings in at $350.43 a month with an $8,550 annual deductible and out-of-pocket max. Although prescriptions are not covered separately, there is 0% coinsurance after your deductible. The same goes for specialist visits. Primary care visits cost $40 with no charge after deductible.

Short-Term Plans for Residents of Colorado

Due to the thriving Marketplace, you’ll find relatively few short-term medical indemnity plans when searching for affordable health insurance in Colorado. However, you do have four choices from UnitedHealthcare you can select.

The basic indemnity plan pays $1,000 per day per accident and $2,000 per illness for up to 31 days of hospital confinement. It pays $100 toward doctor’s visits, with two allowable trips yearly. It doesn’t cover prescription drugs, but it does allow you to add dental and vision coverage. It costs $137.36 per month.

The ultimate indemnity plan pays $5,000 per day for accidents and $10,000 for illnesses for up to 31 days of confinement. It does not cover prescription drugs, but it pays $100 for up to five doctor visits yearly.

Find Affordable Health Insurance in Colorado 

If you need affordable health insurance in Colorado, you have many options. Get yourself and your family the coverage you need today.